Pandemic H1N1 claimed 70 children in EnglandSeventy children in England died of pandemic H1N1 influenza between Jun 26, 2009, and Mar 22, 2010, according to a report released in The Lancet by the UK Department of Health. Deaths in children (0 to 18 years) were identified through daily reporting systems and cross-checking of records and were validated by checking laboratory test results or death certificates, the report says. The overall childhood mortality rate was 6 per million population. The rate was highest for children less than a year old, and rates were higher for Bangladeshi and Pakistani children than for white children: 47 and 36 versus 4 deaths per million population, respectively. Fifteen of the children had been previously healthy, while 45 had severe preexisting disorders. Chronic neurologic disease was the preexisting condition linked with the highest mortality rate: 1,536 per million. Nineteen children died before being admitted to a hospital. Forty-five (64%) of the children had been treated with oseltamivir, but only 7 received it within 2 days of illness onset.Oct 27 Lancetstudy abstract

B cell defects may contribute to low response to flu vaccine in elderlyA study in Vaccine found that intrinsic B cell defects associated with aging contribute to a reduced immune response to the influenza vaccine. Researchers found that the specific response of B cells in vitro, as measured by activation-induced cytidine deaminase serum hemagglutination inhibition and generation of switch memory B cells, decreases with age. They write that the study is the first to make such a connection. Previous studies have shown the reduced immune response to flu vaccine with aging to be associated with decreased T cell function. The authors conclude, "These results could contribute to developing more effective vaccines to protect the elderly."Oct 23 Vaccinestudy

GAO advises FDA to improve planning for overseas officesIn a newly released report, the US Government Accountability Office (GAO) advises the Food and Drug Administration (FDA) to enhances its strategic planning and develop a workforce plan for its overseas offices. The FDA in 2008 and 2009 set up offices in China, India, Europe, Latin America, and the Middle East to help ensure the safety of food and drugs imported into the United States. The offices have been working to establish relationships with foreign stakeholders and gathering information about regulated products, the report says. The China and India offices include facility inspectors, who, as of June 2010, had conducted 48 inspections. The agency is working on a strategic plan for the overseas offices but, despite facing challenges in staffing some of the foreign outposts, has not developed a long-term workforce plan, the GAO says. The GAO says the FDA's strategic planning should include the development of performance goals and measures to demonstrate the contributions of the overseas offices to the regulation of imported products. In addition, the FDA should develop a workforce plan to help ensure that it can recruit and retain staff for the foreign offices, the report says.Sep 30 GAO report

Haiti reports modest increase in cholera cases, deathsHaiti's health ministry has received reports of 3,769 cholera cases, including 284 deaths, according to an update on the outbreak yesterday from the Pan American Health Organization (PAHO). The latest total reflects an increase of 427 cases and 25 deaths since the last update on Oct 25. PAHO said 96% of the cases are from Artibonite department, with 4% from Central department. Meanwhile, protesters in the Haitian city of St Marc threw rocks at a cholera treatment center that was set to open, fearing that having a clinic in the town would bring the disease to the city, the Associated Press (AP) reported yesterday. United Nations peacekeepers helped the police fend off the protestors, and health officials assured the crowd that they would try to move the rehydration and treatment center to a different neighborhood in the city. In other cholera developments, a research group from the University of Alberta has found that Vibrio cholerae has antimicrobial properties against gram-negative bacteria such as Escherichia coli and Salmonella Typhimurium. In their report, which appears in the Proceedings of the National Academy of Sciences (PNAS), researchers suggest that cholera's effect against the other bacteria could give it a survival advantage in aquatic environments and may provide clues about cholera's survival between outbreaks.Oct 26 PAHO situation reportOct 25 PNASabstract

Peramivir approved in Japan for infants, childrenBioCryst Pharmaceuticals announced today that its intravenous antiviral drug, peramivir, has received approval in Japan for treating infants and children who have influenza. BioCryst, of Birmingham, Ala., said in a press release that its Japanese partner, Shionogi & Co., intends to secure enough peramivir to treat about 1 million people during the upcoming influenza season. The antiviral drug was approved in Japan in January under the brand name Rapiacta for adults who have uncomplicated seasonal influenza, as well as for patients at high risk for flu-related complications. Phase 3 clinical trials are currently wrapping up in advance of filing for US approval of the drug, according to the news release.Oct 27 BioCryst news release

Cameroon launches 2009 H1N1 vaccine campaignCameroon's health ministry yesterday launched a 2009 H1N1 flu vaccine campaign aimed at priority groups, including healthcare workers, children between ages 5 and 15, pregnant women, and people with underlying medical conditions, the news organization Afrique en lingue reported. The campaign will use 1.3 million doses that Cameroon received from the World Health Organization, and 3,000 healthcare workers will administer the doses during the 5-day event. The health ministry has received 75 reports of 2009 H1N1 infections since the beginning of 2010, according to the report.